| NPI | 1275757528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADOSLAW PELIKS Owner 916-933-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 50669) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 53264) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2014-07-10 |